Occasionally undesirable solid matter develops in brain tissue, and can include, a blood clot (also known as an intracranial hemorrhage), tumor tissue, a cyst, a brain lesion or infected brain tissue. Depending upon the size and location of the solid matter, and the condition of the subject, it may be necessary to remove the solid matter via surgical intervention.
Given the fluid, non-self supporting and pliable nature of brain tissue, especially in the brain cortex, one of the problems associated with this type of surgery is that, once the solid matter has been exposed it can be difficult to maintain visual and physical contact of the solid matter in a working cavity because the brain tissue naturally moves or flows into the working cavity and re-covers the solid matter. Furthermore, once the solid matter has been removed, the brain tissue surrounding the cavity created by resection of the solid matter typically tries to flow into the cavity, making it difficult to visualize the cavity (similar to looking into a collapsed bag or balloon). Keeping both the working cavity and the cavity created by removal of the solid matter open for manipulation and visible, especially when trying to identify the source of bleeding, can be difficult if the surgeon is operating without an assistant.
Another problem associated with the surgery is stopping bleeding that occurs once the solid matter has been removed. Typically, the working cavity is irrigated and then the surgeon looks for the source of blood flowing from the surrounding brain tissue. Often, the surgeon may use one hand to insert a hand-held retractor into the cavity while using the other hand to suction the area while looking for bleeding. Occasionally, the surgeon may use bipolar electrocautery to stop bleeding, which may require releasing the retractor. Alternatively, an absorbent material such as Gelfoam (Pfizer, Inc., New York, N.Y.) soaked in thrombin, can be packed into the cavity. The material may be left in place and irrigated until it peels away from the cavity walls once bleeding has stopped. The process can be repeated until bleeding stops. However, it is important to remove the absorbent material before closing the surgical site.
There remains a need for improved methods and systems to facilitate the removal of solid matter from brain tissue, such as by allowing a surgeon to access a cavity without an assistant, and by providing a way to effectively stop bleeding once the solid matter has been removed.